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High blood pressure management in the elderly improving


A new study from the Institute for Clinical Evaluative Sciences (ICES) shows that high blood pressure (hypertension) is being more aggressively managed in Ontario seniors, with more seniors being prescribed antihypertensive drugs and less discontinuing the medications.

Researchers tracked Ontarians 66 years of age and older who were newly started on antihypertensive drugs between 1994 and 2002. They evaluated the frequency of new prescriptions for antihypertensive drugs, the frequency with which multiple antihypertensives were prescribed concurrently within 2 years of the initial hypertension diagnosis, and discontinuation rates for antihypertensive therapy.


  • 196,451 elderly Ontarians were newly started on antihypertensives between 1994 and 2002 (30,433 of this group had diabetes).
  • The rate of antihypertensive prescriptions increased by 30% during the study period.
  • While 21% of patients newly diagnosed with hypertension in 1994 were prescribed multiple antihypertensives concurrently within 2 years of their high blood pressure diagnosis, this proportion had increased to 40% by 2002.
  • In the group of patients first prescribed an antihypertensive in 1994, 36% discontinued their medication within 2 years; only 21% of patients first prescribed an antihypertensive in 2002 had discontinued all therapy within 2 years.

“Although some studies have suggested that physicians are not aggressive enough in their management of patients with hypertension, our results demonstrate that physician prescribing practices for hypertensive elderly patients have improved substantially in Ontario,” said lead author and ICES associate scientist Dr. Karen Tu.

“Much of this improvement is most likely linked to the implementation of the Canadian Hypertension Education Program (CHEP) formed in 1999 to improve hypertension management in Canada”.

The study, “Hypertension management in the elderly has improved: Ontario prescribing trends, 1994-2002”, is in the June 2005 issue of the journal Hypertension.

Author affiliations: ICES (Dr. Tu, Mr. Duong-Hua); University Health Network, Toronto Western Hospital Family Medicine Centre (Dr. Tu); University of Toronto, Departments of Family and Community Medicine, Family Healthcare Research Unit (Dr. Tu); University of Calgary, Departments of Medicine and Pharmacology and Therapeutics (Dr. Campbell); University of Alberta, Division of General Internal Medicine (Dr. McAlister).

ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy.


  • Julie Argles
  • Media Relations Officer, ICES
  • (416) 480-4780 or cell (416) 432-8143

Read the Journal Article